Jaundice Flashcards
When is clinical jaundice often visible?
> 35 micomols/L
Normal - 3-20
What drugs can cause pre hepatic jaundice?
Methyldopa, sulfasalazine (5 ASA)
What haemolytic anaemias can cause pre hepatic jaundice?
Sickle cell
THalassaemia
Herediatary spherocytosis
Glucose-6-phosphate dehydrogenase deficiency
Haemolytic uraemic syndrome
What are haemolytic uraemic syndrome?
Group of blood disroders characterised by low red blood cells, acute kidney failure, and low platelets. Initial symptoms typically include bloody diarrhea, fever, vomiting, and weakness
What are haemolytic uraemic syndrome? Initial symptoms?
Group of blood disroders characterised by low red blood cells, acute kidney failure, and low platelets. Initial symptoms typically include bloody diarrhea, fever, vomiting, and weakness
What causes Gilbert syndrome?
Autosomal recessive condition causing defective bilirubin conjugation due to deficiency of UDP glucuronyl transferase
Gilbert vs Criggler najjar syndrome cause
Gilbert - mutation in promoter seuquence for UDP - enzyme functional but fewer
Criggler najjar - mutation in coding for enzyme itself - all UDPs non functional or minimal activity
Which is dangerous, criggler najjar or gilbert
CN - can cause neonatal death due to unconjugated hype bilirubinemia
Gilbert does not need treatment
Which is dangerous, criggler najjar or gilbert
CN - can cause neonatal death due to unconjugated hype bilirubinemia
Gilbert does not need treatment
Do malaria and severe rhabdomyolysis cause pre, hepatic or post jaundice?
Pre hepatic
What drugs cause intra hepatic jaundice
Isoniazid, rifmapicin
Pyrazinamide (antibiotic)
Paraceetemol overdose
Autoimmune disorders causing intrahepatic jaundice
Primary biliary chooangitis, autoimmune hep
Other causes of hepatic jaundice
Alcohol
NAFLD
Viral hepatitis A-4, CMV, EBV
Leptospirosis - blood infection from animals
Liver malignancy
Wilsons disease
Drugs causing post hepatic jaundice
Co-amoxiclav, flucloxacillin, COCP, HRT, corticosteroids
WHat structural issues can cause post hepatic jaundice?
Gallstones
Surgical strcitures
Biliary atresia
Malignancy = cholangiocarcinoma, extrahepatic malignancy
What type of jaundice does primary sclerosing cholangitis cause?
Post hepatic
How can pregnancy cause jaundice?
Cholestasis - post heoatc
What jaundice do both parasitic infections and pancreatitis cause?
Post hepatic
Blood tests in jaundice
ALT
AST
Bilirubin
GGT
ALP
albumin
Clotting
FBC incl reticulocyte count and blood smear - haemolysis
LDH
Hwo screen for heamolysis in jaundce
Blood smear in FBC
LDH is increased
How does stool and urine appear in pre hepatic jaundice?
Normal
Which jaundice types do urine appear dark and stool pale?
Hepatic and post hepatic
Which type of jaundice is ALP normal in?
Pre
Hepatic and post = raised
Which type of jaundice is ALP normal in?
Pre
Hepatic and post = raised
